The present invention relates in general to medical dressings, and, more particularly, to surgical dressings.
After surgery, such as thoracic surgery, or the like, it is often necessary to position a medical device leading into a patient. Such a medical device is, for example, a drainage tube positioned in the thoracic area of a patient. With presently known surgical techniques, such a medical device, and especially a chest tube, is anchored to a patient by suturing a heavy suture to the patient, tieing the suture on the patient, then winding that suture around the medical device.
At the present time, removal of a drainage tube such as a chest tube, or the like, is not only painful for the patient and onerous for the doctor, that removal also carries with it the danger of permitting atmospheric air to enter the thoracic cavity. This danger arises because the thoracic cavity is under negative pressure with respect to the atmosphere. Presently known techniques include steps of inserting a chest tube through an incision made in the patient at the time of surgery or in the emergency room, and then carefully sealing the skin opening, from which the chest tube has its egress from the chest cavity, by gauze or tape. In the usual case, after drainage has stopped via the chest tube, arrangements are made to remove the chest tube while at the same time sealing the opening in the skin so that no air will enter the chest. The present practice includes removing the tape, which has been previously placed at the time of surgery, and any suture between the skin and the chest tube, then quickly removing the chest tube within a few seconds of the removal of the sutures. The skin opening is then occluded with sterile gauze, and while the doctor holds the gauze over the opening, a nurse or other assistant will position several wide strips of adhesive tape over the sterile gauze covering the skin opening to form an occlusive dressing.
There are several drawbacks to the presently used technique. Among these drawbacks are: removal of tape from the skin may be painful; additional gauze sponges are required to be ready to occlude the skin opening; and the assistance of a nurse or resident doctor is usually required to complete the removal procedure.
Accordingly, there is need for a dressing which is complete and readily available from the time surgery is performed and a tube, such as a chest tube, is placed in position until that tube is removed.
There is also a need for a dressing which will minimize the pain and discomfort associated with the removal thereof from the patient. In known devices, additional tape makes such removal a painful experience for the patient.
There is also a need for a dressing which permits removal thereof and occlusion of a skin opening performable by a single, unaided person.
While there are many devices known which anchor medical devices to a patient (see, e.g., U.S. Pat. Nos. 2,606,555, 3,677,250, 3,765,421, 3,834,380, 3,856,020, 3,885,560, 3,826,254, 3,895,629, 3,957,048 and 4,057,066), these devices all have drawbacks because the medical device is not anchored in a manner applicable to tubes, such as drain tubes, or require special dexterity to apply. Furthermore, none of these known devices has any provision for readily occluding a skin opening after removal of the medical device.
Attention is specifically directed to U.S. Pat. Nos. 3,918,446 and 4,122,857, which disclose devices for anchoring articles, such as catheters, to a patient. In both of these devices, the article is sandwiched between a pair of pads which are held together adhesively to hold the article in position on a patient. These devices are not amenable for use with drainage tubes. U.S. Pat. No. 4,122,857, in particular, is not amenable for use with articles wherein the area neighboring the skin opening should be protected as well as having the article securely anchored to the patient.
It is noted that both of the just-mentioned patents are directed to holding small intravenous type devices in place, and neither device has any means for sealing or dressing the skin opening after removal of the medical instrument. These devices therefore have several important drawbacks.